Tag Archive for: telemedicine

Will Telemedicine Mitigate Financial Toxicity for Myeloma Patients?

Will Telemedicine Mitigate Financial Toxicity for Myeloma Patients? from Patient Empowerment Network on Vimeo

With the entry of telemedicine into the multiple myeloma care toolkit, there are some real benefits to the cost of care visits. Dr. Sarah Holstein outlines some of the financial benefits that she’s seen for her patients – and how the logistics of scheduling appointments has changed.

See More From the Myeloma TelemEDucation Empowerment Resource Center

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Will Telemedicine Be a Long-Term Survival Tool for Myeloma Patients?

Is Telemedicine Here to Stay for Multiple Myeloma Care?

How Will the Pandemic Impact Multiple Myeloma Trials? 

 

Transcript:

Dr. Sarah Holstein

So, there’s definitely quite a bit of financial toxicity associated with being a patient who has myeloma. There of course is the cost of the drugs and treatments themselves, but there’s also the personal time cost. So, the cost that it takes to perhaps take a half day off of work or a full day of work to see your provider in person, and the flexibility that telemedicine allows, namely being able to do your appointment from either the privacy of your own home or in some cases the privacy of your own office or even your own car, really allows patients to keep going about their business without having to take all that time off to come travel. There’s the cost associated with gas mileage in some cases, costs associated with parking, although thankfully, that’s not a cost that’s occurred here at Nebraska Medicine. But I certainly know that that can be an issue at other institutions and can really add up for patients over time. So, it’s really been so much easier for patients to get in to see me even when my schedule is fairly full, because they don’t have to think about, “Well, I don’t need to leave work an hour, try to go over my lunch break,” or something like that, they can just schedule it and do it from their office.

I think it’s been a good thing for patients and hopefully is cutting down costs for them.

How Will the Pandemic Impact Multiple Myeloma Trials?

How Will the Pandemic Impact Multiple Myeloma Trials? from Patient Empowerment Network on Vimeo

How has the COVID-19 pandemic changed multiple myeloma clinical trials, and how can telemedicine play a role in trials? Dr. Sarah Holstein shares her perspective on how trials were altered and her suggestions for improvements in trials.

See More From the Myeloma TelemEDucation Empowerment Resource Center

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Will Telemedicine Be a Long-Term Survival Tool for Myeloma Patients?

Is Telemedicine Here to Stay for Multiple Myeloma Care?

Are There Limitations of Telemedicine for Multiple Myeloma Patients?

 

Transcript:

Dr. Sarah Holstein

Early on, I was very concerned about the ability to conduct clinical trials during the pandemic, early on, at least in our institution, and I know that there were many others across the country, there was a lot of concern about really limiting what was considered by the IRB (Institutional Review Board) to be an essential contact. They perhaps placed an emphasis on later phase clinical trials and thought that the earlier phase clinical trials weren’t necessarily proving to be a benefit for patients and therefore shouldn’t be opened, and I would have to say that that was not what my thought was. I really think that all clinical trials, whether it’s a Phase I, Phase II, or Phase III or of utmost importance to our patients and are important for their care. So again, early on, I was very concerned about limiting the access of clinical trials to patients. As the pandemic has continued and it’s become clear that this is going to be life as we know it for unfortunately, quite some time, I know at our institution, we’ve really tried to be as safe as possible, but all clinical trials are open and we’re allowed to enroll, I think there still is room for improvement with respect to how telemedicine is incorporated into clinical trials, and whether or not we can do things like allowing patients to get their study labs drawn closer to home as opposed to traveling to the academic center, so I think there continues to be room for improvement for really trying to minimize the amount of traveling that people do, and therefore the amount of potential exposure that patients have.

We still are not routinely using telemedicine for the clinical trial visits, that most of those are still in person. And I think depending on the specific trial, that is probably appropriate if you have a new agent and a lot of what you’re looking for is evidence of toxicity, I think it is important to be able to evaluate the patients in person and really be able to conduct a normal physical exam, having said that though, if a patient’s on a clinical trial where they’re receiving more standard of care, and perhaps it’s in a maintenance phase of a study, I think being able to utilize telehealth for some of those more routine visits would really be beneficial for both the patients and the healthcare team.

Is Telemedicine Here to Stay for Multiple Myeloma Care?

Is Telemedicine Here to Stay for Multiple Myeloma Care? from Patient Empowerment Network on Vimeo.

With the emergence of telemedicine for multiple myeloma care, it’s being looked at for long-term care. Myeloma expert Dr. Sarah Holstein shares her hopes for the future of telemedicine – and shares some tips for optimizing telehealth visits.

See More From the Myeloma TelemEDucation Empowerment Resource Center

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Will Telemedicine Be a Long-Term Survival Tool for Myeloma Patients?

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Transcript:

Dr. Sarah Holstein

I really hope telemedicine is here to stay. If you’re practicing in a place like I am, where patients come from quite a distance, it would be great in the future if some of the more routine visits, can be a telemedicine and perhaps get into a rotation or maybe every three or four months, they come and see me in person versus the rest of their monthly visits via telemedicine. So, I very much hope that the government, as well as insurance carriers will continue to provide coverage for telehealth visits in the future, because I think it’s really broadened access for patients and it’s been a really wonderful thing for them in general. In terms of tips for preparing, some of it just comes down to understanding the technology and getting familiar with what you need to click on and making sure that you’ve allowed your iPad or your phone or computer access to your camera, it sounds silly, but sometimes a big chunk of the appointment can be eaten away because of the settings being wrong or pop-ups, so some of it is just trying to figure out the system ahead of time before you log on.

But other than that, I would say, making sure that you understand from your health care team, whether or not you can forward the link, if you’re using Zoom, for example, to other family members, so that you

can have multiple family members kind of Zoom in at the same time to be able to listen, and that way you’re not relying on yourself to take notes, and everybody doesn’t have to be in the same place at the same time, which again, given the pandemic is not wise anyways. So, I think just trying to figure out the technology involved and then making sure that you can have access or provide access to your family members or friends who want to virtually come to your visit with you is key for a successful visit.

Will Telemedicine Be a Long-Term Survival Tool for Myeloma Patients?

Will Telemedicine Be a Long-Term Survival Tool for Myeloma Patients? from Patient Empowerment Network on Vimeo

What can multiple myeloma patients expect for the use of telemedicine as part of their long-term care? Dr. Sarah Holstein shares her experience of using telemedicine for those with MGUS and those managing controlled disease – and her thoughts about the future of telemedicine.

See More From the Myeloma TelemEDucation Empowerment Resource Center

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Are There Limitations of Telemedicine for Multiple Myeloma Patients?

How Can Myeloma Patients Reduce Infection Risks During Medical Appointments?

What Are the Benefits of Telemedicine for Myeloma Patients?

 

Transcript:

Dr. Sarah Holstein

So, I think telemedicine is a really good fit for patients for either long-term survivorship issues or for patients that perhaps you’re just following with the precursor to myeloma, so for example, MGUS (monoclonal gammopathy of undetermined significance) where overall the risk is low that there’s actually going be a progression to myeloma over their lifetime.

So I have a number of patients who I see perhaps on an annual basis for those types of visits, and of course, over the last year, I’ve been doing a number of those visits via telehealth, and I think they’ve gone really well. It still allows me to ask my entire review of systems where I check through and make sure that there’s no subtle signs that I might be missing that somebody’s plasma cell disorder is progressing. They’ve had their blood work or scans or other testing done, and we can review those, but again, in those types of situations where the risk is low and somebody is doing well and it’s a fairly routine visit, I think the need to do a full physical exam, it’s pretty low, I think whether or not you’d hear anything on the lung exam in somebody who’s doing well and it’s just there for an annual basis exam, I don’t think that lung exam is going to add a whole lot, but really having the ability to still talk to each other, go over laboratory studies, really make sure that I’m not missing any subtle signs that might suggest concomitant lite amyloidosis or progression to myeloma can still very readily be done via telehealth.

What Are the Benefits of Telemedicine for Myeloma Patients?

What Are the Benefits of Telemedicine for Myeloma Patients? from Patient Empowerment Network on Vimeo

How will myeloma patients benefit from telehealth visits? Myeloma expert Dr. Sarah Holstein shares benefits she has seen while caring for her myeloma patients including broadening access and the ease of seeking a second opinion.

See More From the Myeloma TelemEDucation Empowerment Resource Center

Related Resources:

 

Is Telemedicine Here to Stay for Multiple Myeloma Care?

Will Telemedicine Mitigate Financial Toxicity for Myeloma Patients?

How Will the Pandemic Impact Multiple Myeloma Trials? 

 

Transcript:

Dr. Sarah Holstein

So, I think telemedicine has been one of the few silver linings of this entire pandemic, I had personally never utilized telemedicine previously in my career, and now I’m using it almost extensively these days to care for my myeloma patients.

I’ve always had patients who tell me that they wish they didn’t have to take a half day off to come to a clinic appointment, and sometimes the clinic appointments are only 20 minutes, but they’re driving an hour and a half or two hours or more to come to those clinic appointments. So, some of it has just been the freedom that allows patients to go about their lives and not have to take time off of work or time off from other things that they’re doing to physically travel to come and see me. Telemedicine though, has also really broadened the access to me in my cancer center, again, based on where I’m at in Nebraska, patients would sometimes have to travel a very far distance to see me, and these days it’s just a matter of logging on via Zoom to access me, and it’s allowed me to see patients for second opinions in not only different parts in Nebraska that otherwise would have been difficult to reach, but also really across the country.

So, telemedicine in general, has allowed patients much more flexibility in seeing me and has also allowed the ability for me to do second opinions without making patients travel quite a distance.

Step-By-Step Guide to Using Telemedicine

Step-By-Step Guide to Using Telemedicine from Patient Empowerment Network on Vimeo.

The ultimate guide for a successful and safe telemedicine visit with your doctor that includes practical and actionable tips to help you utilize telemedicine to your advantage.


Transcript:

Andrea Conners

Hi, I’m Andrea Conners the Executive Director of Patient Empowerment Network. It’s my pleasure to talk with you about telemedicine and offer some practical and actionable tips to help you utilize telemedicine to your advantage, both now and the foreseeable future due to COVID. As well as, throughout your healthcare journey.

So, let’s start at the beginning with what exactly is telemedicine? Whether it is an appointment with your nurse, doctor, or mental health provider, there are times when it could make more sense to meet with a member of your healthcare team virtually using your computer or mobile device.

This approach may offer more flexibility and cut down on your time in the car or in the waiting room and, of course, decrease your exposure to illnesses such as COVID. If telemedicine is available to you through your doctor’s office or hospital you can see your health care provider for an appointment without leaving your home using a few simple steps which I’ll walk you through now.

The first step is scheduling your appointment, step two is preparing for your appointment, and step three is understanding what to expect on the day of your appointment. Utilizing these three steps will ensure you have a stress free and successful telemedicine visit.

It’s important to keep in mind that every provider’s technology is slightly different. The platforms and instructions you receive for your telemedicine visit may vary for each healthcare system. That being said, there are a few things you will need. The first is a strong Internet connection like a home Wi-Fi network. The other requirement is a computer or mobile device like a tablet or your smartphone. The device should have a webcam so that your provider can see you and a microphone so that you can communicate with the provider. Both of these are standard on most mobile devices.

Once you have confirmed that you have the necessary equipment and tech requirements, the next step is to ensure your physician or clinic has options for telemedicine. You can do this by calling the appointment staff. You may be able to see the options for virtual appointments when you log on to your patient portal that your provider has once the appointment is scheduled.

It’s important to ask how you will receive instructions for the appointment. Providers might send information to your email address or through your patient portal messaging system. Be sure to ask for telephone number in case you have technical difficulties.

After you’ve scheduled your appointment, it’s time to get prepared here’s a pro tip for you, don’t use a public Wi-Fi connection to access personal information as it can be easily compromised. If you’re going to use Wi-Fi, it’s best to do it from home on a secure connection. It’s important to also note that because you will be sharing health information during the virtual visit, your provider will use the technology that protects your information.

Here are some tips for preparing for your telemedicine appointment:

First, review the instructions that you received from your provider. Then, log on to the portal to familiarize yourself with the process and the software. Once again, every health care system is set up a bit differently so follow the provided instructions closely.

Be sure to test your system. Most software offers this option, and you can test well in advance of your appointment.

Lastly, ensure that your audio and video are working properly. If not, refer to the instructions or call the designated number to get assistance.

On the day of your appointment, login at least 10 minutes early. You may have to fill out an intake form just like you do at a regular visit or sign a consent form for care, this will all be done online. Also, and this is really important, make sure your device is fully charged. Just like an in-person appointment, there may be some time that you spend in your virtual waiting room so you’re going to want to make sure that your computer or your smartphone has enough battery to last the entire visit.

A few more things to keep in mind: make sure the sound, camera, and microphone on your device are turned on and check the levels are up and not muted. This is another really important one, be patient. As with most video calls, it takes some time, even a few minutes, for everyone to be able to hear and see each other.

Be prepared. Write down questions and topics you would like to address with your provider in advance, and just know, that there may be follow up you need to complete following the appointment, such as lab work. If that’s the case, your doctor will provide specific instructions on how best to handle this.

One important thing to note when deciding between a telemedicine versus an in-person appointment is that telemedicine is not for emergency situations. And although it might not replace an in-person appointment, some types of non-emergency follow up and monitoring appointments might be possible to conduct virtually.

Mental health resources, such as online counseling, are also often available through telemedicine. When in doubt, your health care provider can help you determine if a virtual appointment is an option for you and the best option for you.

So, all of this might leave you wondering is telemedicine just a passing trend that will go away after the pandemic is over? 54% of physicians surveyed said that they will continue to utilize telemedicine to serve their patients after the pandemic has ended. So, it appears that telemedicine is here to stay.

I know I’ve covered a lot of information in a very short period of time so if you would like to learn more I invite you to visit PEN’s website and take the full Digitally Empowered® course where you’ll learn all sorts of digital skills that will help you become more tech-savvy and empower your health care journey. The courses free self-paced and available to you at anytime you can access it using the URL (iamdigitallyempowered.org) in the green box on this slide.

Before I let you go, I’d like to tell you more about my organization Patient Empowerment Network, also known as PEN, in case you’re not familiar with us. PEN is a pan-cancer advocacy organization that focuses on increasing health and digital literacy for patients and care partners. We provide free online programs and resources designed to educate and help activate patients and care partners to share in decision making with their care team. We do this because we know that empowered patients like all of you typically achieve better health outcomes. Please join our network of empowered patients. Thank you for your time.

Newly Diagnosed with Prostate Cancer? Consider These Key Steps

Newly Diagnosed with Prostate Cancer? Consider These Key Steps from Patient Empowerment Network on Vimeo.

For those who are newly diagnosed with prostate cancer, figuring out what to do next can be overwhelming. Prostate cancer survivor Jim Schraidt outlines advice for patients to encourage self-advocacy and to access resources and support.

Jim Schraidt is a prostate cancer survivor and Chairman of the Board of Directors for Us TOO International. Learn more about Jim Schraidt here.

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Transcript:

Jim Schraidt:

If you’re newly diagnosed, get a second opinion on your biopsy slides. Because reading those slides is as much an art as it is a science. And we’ve had people who will come to our support groups who then went on to have their slides reviewed on a secondary basis. And it’s changed their diagnosis. In one case, a guy discovered that he actually did not have prostate cancer.

And in other cases, it’s changed the grading of the cancer that’s identified in the biopsy, which of course then impacts treatment decisions, whether it’s active surveillance, surgery, radiation, or systemic therapy. So, that would be the first thing. I think the other thing, and I that think this is true for most medical issues, is to get a second opinion, take the time to get a second opinion.

And in the case of prostate cancer, try to do it at a medical center that takes a multi-disciplinary approach to the disease. So, you would be meeting at the outset with a urologist, a radiation specialist, and perhaps a medical oncologist who can really take you through the options, the treatment options for your situation.

And then I guess the final of three items that I would say is find a support group. And even if you want to just join one of the virtual groups and listen and learn, that’s perfectly fine. But learn about the disease you have, and learn about the treatment options, and learn the things that you need to ask your medical practitioners to help you get the best outcome.

Because the happy patient is going to be the one that knows what he’s getting into and makes and accepts that as part of his decision and can focus after treatment on healing and not on treatment regret.

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Will Telemedicine Improve My Quality of Life with CLL?

Will Telemedicine Improve My Quality of Life with CLL? from Patient Empowerment Network on Vimeo.

How do chronic lymphocytic leukemia (CLL) patients and care partners feel about the impact of telemedicine on quality of life? Watch as a CLL patient and care partner, Bob and Susan, discuss how easier access to blood test results affects patient emotions before and during remote office visits.

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Transcript:

Susan Bottega: 

The role of telemed in terms of survivorship I think is a very, very interesting subject. CLL patients are living a very long life these days with the onset of the novel agents that are coming out. Quality of life becomes a very, very important subject for CLL patients. So much of their quality of life is diminished by the visits that they have to make into doctors’ offices.

The anguish that they spend the day before, the sleepless night that accompanies the doctor’s visit. I think that this is extremely important. You’re looking very possibly of at least two days taken out of your life, and if you’re making these visits on a monthly basis or bi-monthly basis or even tri-monthly basis, that’s a long period of time to take out of the span of your lifetime. And as we’re living longer, this becomes more and more important.

You want to have that quality of life, you want to be able to go on vacations. Your vacations can’t be postponed because you have a doctor’s appointment looming in the future. You can take your computer right along on vacation with you and share your vacation with your doctor.

Bob Bottega:

I like that.

Susan Bottega:

I think the anguish that you feel about blood tests is diminished by it. You don’t have to wait to get the results of your blood tests, your blood tests pop right up on your patient portal. You don’t have to sit there and wait in a doctor’s office until you see those results.

Once you see your doctor, you’ve already got your results and you’re calm about it, you’re relaxed because you know what the results are and you can discuss them without having to deal with the anxiety that comes with hearing, “Okay, my white blood cell count has gone up considerably, so how do I calm myself down to discuss this intelligently at this point in time when I’m emotionally so upset over it?” I think these are very, very important things about the quality of your life. How about you, Bob?

Bob Bottega:

I think you said it all.

Susan Bottega:

Don’t I always? (laughter)

Dr. John Pagel’s Top Tips for Preparing for Your CLL Telemedicine Visit

Dr. John Pagel’s Top Tips for Preparing for Your CLL Telemedicine Visit from Patient Empowerment Network on Vimeo.

For chronic lymphocytic leukemia (CLL) patients, telemedicine has emerged as an option that requires new ways of working with their health team. Watch as CLL expert Dr. John Pagel shares his advice to patients and caregivers for getting the most out of telemedicine visits.

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Transcript:

Stephanie Chuang: 

You had mentioned, patients need to be prepared when they come to their telemedicine visits, doctors have limited time, of course. So what are your top three tips or so for patients and their caregivers who are preparing for their telemedicine visit?

Dr. John Pagel: 

So here’s a good important thing to say around that. Number one, you know, what happens is you’ll get told you have a telemedicine visit at 10:00 AM on Tuesday. And so you’re looking forward to 10:00 AM on Tuesday. And 10:00 AM comes around, and you’re waiting by the phone, and it doesn’t ring immediately, or the Zoom doesn’t come up immediately, please understand you have to be a little bit flexible with your physician. Just because it says that time…it’s the same thing kind of like in the clinic, it all kind of flows and works together. And so please be flexible and be patient. Not accepting excessive delays, that’s not really cool, we get that, but it’s often very hard to be right on the dot at 10:00 AM. So number one, be flexible. Number two, have your questions written out or focused about what you want to learn and understand that visit. It may not be a lot different than the last visit, that’s okay. But if you don’t have those, often, what will happen is that when the visit’s over the phone is hang up or the Zoom call is put away, you’ll remember, “Oh, I forgot to ask X, Y, or Z.” don’t let that happen.

And the way you don’t let that happen is to be focused there with what you want to learn. And then lastly, if it’s possible, don’t be excessive. Meaning that, focus on the things that are important, meaningful, relevant to what’s happening to your health, your disease in your interaction with your physician. There are things that we all can list that could be very, very long in the list, but many of them aren’t going to be something that the physician can get to in a very meaningful, important way. Ask though, if you can’t get to those things that are important, that you try and follow up with them very quickly, perhaps in another visit relatively soon. But keep your expectations, if you could, to a very realistic approach, directed and focused on taking care of you and managing your CLL. 

Will Telemedicine Be a Long-Term Survivorship Tool for CLL Patients?

Will Telemedicine Be a Long-Term Survivorship Tool for CLL Patients? from Patient Empowerment Network on Vimeo.

With telemedicine as a part of the chronic lymphocytic leukemia (CLL) toolkit, what will its role be in the future? Watch as CLL expert Dr. John Pagel shares his viewpoint of how telemedicine will play into long-term survivorship care for patients.

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What CLL Population Will Benefit Most From Telemedicine?

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What CLL Symptoms Can Be Monitored via Telemedicine?

 

Transcript:

Stephanie Chuang: 

We really haven’t scratched the surface, it seems, when it comes to using telemedicine as a long-term survivorship tool. So for the sub-group of CLL patients who never need treatment, does telemedicine still bring any major advantages?

Dr. John Pagel:

There are people, and it’s not uncommon, who actually never even get treated. I’ve had people in my clinic who have had CLL diagnosed and never treated for over 20 years or more. It does happen. And those people often can be managed with their primary care physician, even though it’s good to have a CLL focused clinician, an oncologist or even expert in their back pocket, but they may only need to have that televisit with that expert or oncologist once a year. So those are the ideal kind of patients who it’s not great to drag them in if there’s nothing going on with them, but they still need to be evaluated and have a discussion about what’s happening, at a minimum once a year in many cases. 

What CLL Symptoms Can Be Monitored via Telemedicine?

What CLL Symptoms Can Be Monitored via Telemedicine? from Patient Empowerment Network on Vimeo.

For chronic lymphocytic leukemia (CLL) patients, some symptoms can be monitored via telemedicine, while other symptoms are best to check in-person. Watch as CLL expert Dr. John Pagel discusses getting optimal care by CLL symptom type.

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What CLL Population Will Benefit Most From Telemedicine?

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Transcript:

Stephanie Chuang: 

There are CLL patients on specific treatment protocols and those who need follow-up for potential adverse effects of treatment compliance and, of course, progress. And so the question is, how effective of a tool is telemedicine for this group?

Dr. John Pagel: 

I’ve been very impressed that we can meet the needs of patients, we can meet the needs for clinical trials. Clinical trials have really adopted and been flexible with the idea of being able to do telemedicine in a large degree because of COVID in CLL. And I would say clearly that a conversation and close discussion with the physician’s critically important, it comes back to what we mentioned specifically, it’s about education. Patients need to understand that if they’re not feeling well, meaning, they’re having drenching night sweats or they’re losing weight or they’re having pain, those aren’t things to sit back and just wait for your telemedicine visit, they need to contact the physician and to be able to be seen urgently or quickly if needed. 

Telemedicine is going to be a bridge to make that happen, but in general, those are people that are in a bit of a different class of what we’re discussing here today. So monitoring disease, taking care of people with regard to assessments of their blood counts can be done all again through telemedicine, but more acute problems, those patients do, of course, need to be seen. 

TelemEDicine ToolBox Visit Checklist

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Will Telemedicine Give More CLL Patients Access to Clinical Trials?

Will Telemedicine Give More CLL Patients Access to Clinical Trials? from Patient Empowerment Network on Vimeo.

Though some with chronic lymphocytic leukemia (CLL) may have limited access to clinical trials at expert centers, telemedicine may change access for some patients. Watch as Dr. John Pagel shares how telemedicine might improve CLL clinical trial options. 

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Transcript:

Stephanie Chuang: 

There is a lot of attention being paid to clinical trials and progress, and so how might telemedicine impact clinical trials when it comes to CLL therapy?

Dr. John Pagel: 

Well, I want to first tell the audience that clinical trials are critically important for many patients who have CLL. Clinical trials are really an opportunity to get something that’s better than the standard of care most often, or at least just as good and has the promise again, to be better. We have advanced major new paradigm changing therapies over the last many years through clinical trials, and now we’re looking at really exciting things like bispecific antibodies, newer generations of these targeted therapies that are better tolerated and perhaps even more active in resistant patients. And even as we talked about CAR T-cell therapies, those are all only available through clinical trials, and then that’ll continue to evolve and go on as well.
 
I would encourage patients to think about clinical trials, and because of telemedicine, now we’re going to be able to reach to other patients who are further away from an expert, perhaps where clinical trials are only available, and they can be then involved in one of those opportunities. Telemedicine, I hope, and I believe, will be a major advance for getting the cutting-edge, best therapies for patients who might be very far away from a very important expert center.